ABSTRACT
Fasting during Ramadan may be a cause of poor glycaemic control in diabetic patients. To assess glucose excursions during Ramadan by using a continuous glucose monitoring system [CGMS]. The interstitial glucose level was recorded over 72 hours during Ramadan and three months later, in five type 2 diabetic patients, aged 56 +/- 5, treated with glimepiride and metformin. During Ramadan, four patients experienced at least one episode of low glucose level [<0.7 g/l] during the monitoring. The frequency of these episodes was 0.6 episode/d with an average duration of 36 mn / d. These episodes occurred in the morning in half of the cases and in the hour before breaking the fast in 37.5% of the cases. Four patients experienced at least one episode of high glucose level [>1.8 g/l], with an average duration of 403 mn /d and with a frequency of two episodes /d. More than half episodes [53] occurred after the breaking of the fast. After Ramadan, CGM records showed at least one episode of low glucose in two patients with an average duration of 58 mn /d and a frequency of 1.3 episodes/d. Three patients experienced at least one episode of high glucose level with an average duration of 525 mn /d and a frequency of 1.46 episodes/day. The blood glucose profile of our patients during Ramadan is characterized by important glycaemic excursions
ABSTRACT
To report a new case of hypoparathyroidism in a child with beta thalassemia major. We report a case of a 17-year-old Tunisian girl with transfusion-dependent thalassemia major presented with paresthesia and pubertal delay. Laboratory investigations showed hypocalcaemia and hyperphosphatemia. Parathyroid hormone level was low [2 ng/1, normal range: 12-72 ng/1] than expected for the degree of hypocalcaemia. Serum ferritin concentration was 1770ng/ml. The patient was started on oral daily calcium supplementation, Alfa calciferol and intensive iron chelation therapy. Follow-up after 6 and 12 months revealed normal Calcium and ECG showed QT intervalwithin normal range. Investigating calcium homeostasis at regular intervals and early management of any abnormality can preclude the occurrence of complications